U.S. Says 15,000 Health-Care Enrollments Didn’t Get to Insurers

Photographer: Robyn Beck/AFP via Getty Images

About 365,000 people have enrolled in federal health-care nationwide, including in states such as California, New York, Kentucky and Washington that run their own systems and have reported fewer technical problems. Close

About 365,000 people have enrolled in federal health-care nationwide, including in... Read More

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Photographer: Robyn Beck/AFP via Getty Images

About 365,000 people have enrolled in federal health-care nationwide, including in states such as California, New York, Kentucky and Washington that run their own systems and have reported fewer technical problems.

The government failed to send data to health insurers for about 15,000 people who enrolled in Obamacare through early December, an error corrected last week before it could jeopardize their coverage, the U.S. said.

The percentage of enrollments that aren’t transmitted to insurers, a process known as an “834 transaction” is now close to zero, the Centers for Medicare and Medicaid Services said in a report yesterday.

While the government announced Dec. 1 that it fixed many of the bugs and errors that had frustrated consumers using its insurance-enrollment system, garbled back-end communications with carriers have taken longer to sort out. The data transmissions are critical to complete the enrollment of millions of people seeking coverage under the 2010 Patient Protection and Affordable Care Act that was the signature domestic achievement of President Barack Obama’s first term.

“Our priority is working to make sure that every 834 form -- past and present -- is accurate, and that consumers are able to successfully enroll in the coverage of their choice,” Julie Bataille, a spokeswoman for the U.S. Centers for Medicare and Medicaid Services, said in a blog post yesterday.

The 834 form, which provides insurers information including new customers’ names, addresses, gender and Social Security numbers, is generated at the end of the sign-up process after a health plan is selected. No data was transmitted as much as 15 percent of the time in the middle of October, according to yesterday’s report. The enrollment system and its website, healthcare.gov, at that time were plagued with errors, and federal technicians had only just begun a repair effort.

‘Getting Better’

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the industry’s Washington lobby group, said the group couldn’t confirm specific error rates for the data transmissions. Problems with the forms have been subsiding, he said in a phone interview.

“The enrollment files are getting better,” Zirkelbach said. “The process they’ve put in place over the last couple weeks to address the back-end challenges is making a difference. There are still issues with the 834s that have to be resolved to make sure people are enrolled.”

In addition to forms that aren’t sent to insurers at all, Bataille’s agency has also sent duplicate forms and forms with incomplete data. Those problems aren’t considered as serious because insurers can correct the errors and complete customers’ enrollment. Insurers can’t enroll people whose 834 forms aren’t sent to them, a category of customer known as “orphans.”

Falling Rates

By Dec. 5, the rate of failed transmissions had fallen to less than 1 percent, according to yesterday’s report. About 137,000 people had selected a health plan using the federal system by the end of November, according to the government.

The federal system serves 36 states, including Texas and Florida. About 365,000 people have enrolled nationwide, including in states such as California, New York, Kentucky and Washington that run their own systems and have reported fewer technical problems.

The health agency said in a statement yesterday that the enrollment system was being shut down for about 12 hours starting at midnight Washington time and ending roughly at noon today for unspecified maintenance. The shutdown includes the federal enrollment website, healthcare.gov, as well as a system called the data services hub that states with their own enrollment systems use to confirm information about their customers, such as citizenship and Social Security numbers.

Bataille’s agency earlier this month shared all of its enrollment data with about 300 insurers participating in the federal system. That process, separate from the 834 transmissions, allows the plans to double-check their enrollment information against the government’s records.

“We are double and triple-checking all enrollment data across systems,” Bataille said in her post.

Americans who want coverage that begins Jan.1 have to sign up by Dec. 23. Bataille said the government will conduct another round of data reconciliation with insurers after that deadline.

To contact the reporter on this story: Alex Wayne in Washington at awayne3@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

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